Proposal Would Undermine Federal Family Planning Program

Access to quality family planning and reproductive health services is integral to overall good health for women, men, and adolescents. Ensuring that all Texans have access to the tools to let them plan the size and timing of their families is critical to building economic and social opportunity.

There is only one federal grant program dedicated exclusively to providing low-income people with essential family planning and preventive health services – Title X (pronounced “Title ten”). The Title X Program is a crucial component of family planning in Texas, providing needed access to preventive and preconception care. In 2016 alone, Title X served 183,000 Texans, preventing an estimated 41,090 unintended pregnancies.[i] Title X also has saved Texas taxpayers money — more than $7 in medical costs saved for every one dollar spent on family planning.[ii] Title X’s positive impact stems in large part from the requirements governing these funds that have emphasized high-quality, science-based, client-centered care, helping people to plan their families and their lives.

CPPP recently commented on proposed federal rules that will have devastating negative effects on the Title X family planning program and the low-income patients for whom Title X provides critical health care. The proposed rule would move Title X away from its historical focus on making modern family planning tools available to all, regardless of income. The proposal will instead prevent highly qualified, trusted family planning providers from continuing in their long-standing Title X roles; and destabilize the effective network of Title X providers. For these reasons, CPPP has urged the U.S. Department of Health and Human Services (US HHS) to withdraw the proposed rule.

Key concerns highlighted in our rule comment include:

The proposed rule would exclude certain qualified providers — Planned Parenthood and others — from the Title X program, putting at risk access to critical primary and preventive care services for more than 40 percent, or nearly two million Title X patients. In Texas, we have seen first-hand the harmful consequences of excluding Planned Parenthood and other organizations from the Texas Women’s Health Program, a state-funded family planning program.
In Texas, other providers have been unable to adequately fill the gap. Academic research and the state’s own data show that after Texas excluded Planned Parenthood, provider capacity dropped; dramatically fewer women received critical health care services; access to the most effective forms of contraception was reduced; and costs to Medicaid increased.

The proposed rule undermines access to evidence-based, effective family planning methods. It removes the current requirement that methods of family planning be “medically approved,” and makes it easier for entities that offer only one family planning method to participate. The proposal would reduce access to safe and effective contraception and threaten the historic progress made on reducing the unintended pregnancy rate in the U.S

The proposed rule deemphasizes the role played by specialized family planning providers, which could displace community clinics from the program and shutter clinics operating in rural areas where there are no close-by primary health providers. Clinics that specialize in family planning play a critical role. They are more likely to ensure patients have access to the full range of contraceptive methods and medical technology — while serving a higher volume of patients, often at lower cost per patient. In Texas, we already have seen that diverting funds away from clinics that specialize in family planning means fewer women are served.

The proposed rule, if adopted, would further weaken Texas’ network of family planning providers for low-income and uninsured residents and further reduce access to critical preventive care in our state.

You can find more information on Title X and the proposed rule at the National Family Planning and Reproductive Health Association’s Title X webpage.

Stacey Pogue joined the center in 2008. She focuses on health policy issues. Before coming to the center, she did health policy and research work with the Medicaid and CHIP Division of the Health and Human Services Commission and the Texas Department of Insurance. In 2010 and 2011, she was selected to serve as a funded Consumer Representative to the National Association of Insurance Commissioners (NAIC). Pogue earned a Bachelor of Science in Geography, summa cum laude, from Texas A&M University in 1997 and a Master of Public Affairs from the LBJ School of Public Affairs at The University of Texas at Austin in 2005.